Laurence Allen Hickman Jr., RPH
Individual provider Active NPI Pharmacist · Williamsport, MD
NPI 1417042011 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1417042011
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 09892 (MD)
- Practice address
- 307 East Potomac Street
Williamsport, MD 21795-1203 - Phone
- (301) 223-4100
- Fax
- (301) 223-6133
- NPI assigned
- Oct 3, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 09892 | MD | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Antietam Health Services | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 09892 | MD | Yes |
Addresses
Primary practice location
307 East Potomac Street
Williamsport, MD 21795-1203
Mailing address
13125 Lenape Lane
Waynesboro, PA 17268-8420
Phone (717) 762-7032
Other providers in Williamsport, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.